4361 Onyx Dr - Inspection FormCity {II' Capri
Residential Sanitary Sewer Service
Compliance Inspection
Date / 1/
Name 12 s , / /
PID Number
House Number - f . S t reet Name i� / J
Alternative Mailing Address
r
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Roots - %-
Damaged Pipe
II
Transition
4" to 6" Transition:
White Copy: Property Owner
Time
Disk #
Owner /Occupant Signature
aril
PM
Phone / 7 6 ° l ?� /�° "°�•� !i
Length of Service:
Yellow Copy: City of Eagan
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
1
Record Number.
p Time
Obstruction
Unable to push past
feet
•
•
e
Inspector Signature
For information caI 165 1:470.2788
Service Lateral lnspe tion Finding Number of $ tacks _ _ Entered S. L at - i :2 1?
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Cleanout: /
am
f pm
Pink Copy: SEH
Notes
G V
^
) -!
) t /
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
/ `
Foundation drains
LI
Roof drains
/'
City {II' Capri
Residential Sanitary Sewer Service
Compliance Inspection
Date / 1/
Name 12 s , / /
PID Number
House Number - f . S t reet Name i� / J
Alternative Mailing Address
r
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Roots - %-
Damaged Pipe
II
Transition
4" to 6" Transition:
White Copy: Property Owner
Time
Disk #
Owner /Occupant Signature
aril
PM
Phone / 7 6 ° l ?� /�° "°�•� !i
Length of Service:
Yellow Copy: City of Eagan
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
1
Record Number.
p Time
Obstruction
Unable to push past
feet
•
•
e
Inspector Signature
For information caI 165 1:470.2788
Service Lateral lnspe tion Finding Number of $ tacks _ _ Entered S. L at - i :2 1?
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Cleanout: /
am
f pm
Pink Copy: SEH